Asuhan Keperawatan pada CVA dengan Gangguan Mobilitas Fisik melalui Penerapan Latihan Range of Motion (ROM) di Ruang ICU RSUD Bhakti Dharma Husada Surabaya

Latar Belakang: Cerebrovascular Accident (CVA) merupakan penyebab utama kecacatan yang sering mengakibatkan gangguan mobilitas fisik akibat hemiparesis, penurunan kekuatan otot, serta keterbatasan rentang gerak. Kondisi tersebut dapat meningkatkan risiko komplikasi imobilisasi apabila tidak ditangani secara tepat. Salah satu intervensi keperawatan yang dapat diberikan untuk mempertahankan dan meningkatkan fungsi gerak adalah latihan Range of Motion (ROM). Tujuan: Mendeskripsikan asuhan keperawatan pada pasien CVA akut dengan gangguan mobilitas fisik melalui penerapan latihan Range of Motion (ROM) di Ruang ICU RSUD Bhakti Dharma Husada Surabaya. Metode: Penelitian ini menggunakan desain studi kasus dengan satu responden yang dirawat di Ruang ICU RSUD Bhakti Dharma Husada Surabaya. Pengumpulan data dilakukan melalui wawancara, observasi, pemeriksaan fisik, dokumentasi rekam medis, serta pengukuran kekuatan otot menggunakan Manual Muscle Testing (MMT). Proses asuhan keperawatan meliputi pengkajian, penetapan diagnosis, perencanaan, implementasi, dan evaluasi selama tiga hari. Hasil: Hasil pengkajian menunjukkan pasien mengalami hemiparesis sinistra dengan kekuatan otot ekstremitas kanan 5/5 dan ekstremitas kiri 3/3. Diagnosis keperawatan yang ditegakkan adalah Gangguan Mobilitas Fisik berhubungan dengan gangguan neuromuskular (D.0054). Intervensi yang diberikan berupa latihan ROM pasif pada ekstremitas kiri, disertai edukasi dan pelibatan keluarga dalam pelaksanaan latihan. Setelah dilakukan implementasi selama tiga hari, terjadi peningkatan kemampuan mobilitas yang ditandai dengan meningkatnya kekuatan otot, pergerakan ekstremitas, dan rentang gerak dari 3/3 menjadi 4/4. Kesimpulan: Penerapan latihan Range of Motion (ROM) sebagai bagian dari asuhan keperawatan mampu meningkatkan mobilitas fisik pada pasien CVA dengan gangguan mobilitas fisik. Intervensi ini dapat dijadikan salah satu tindakan keperawatan berbasis bukti untuk mendukung proses rehabilitasi dini serta mencegah komplikasi akibat imobilisasi.

================================================================================================

Background: Cerebrovascular Accident (CVA) is a leading cause of disability that often results in physical mobility problems due to hemiparesis, decreased muscle strength, and limited range of motion. These conditions can increase the risk of immobilization-related complications if not managed properly. One nursing intervention that can be given to maintain and improve movement function is Range of Motion (ROM) exercises. Objective: To describe nursing care for acute CVA patients with physical mobility impairments through the application of Range of Motion (ROM) exercises in the ICU at Bhakti Dharma Husada Hospital Surabaya. Method: This study used a case study design with one respondent who was treated in the ICU of Bhakti Dharma Husada Hospital Surabaya. Data was collected through interviews, observation, physical examination, medical record documentation, and muscle strength measurement using Manual Muscle Testing (MMT). The nursing care process included assessment, diagnosis, planning, implementation, and evaluation over three days. Results: The assessment results showed the patient had left-sided hemiparesis with muscle strength of 5/5 in the right extremities and 3/3 in the left extremities. The nursing diagnosis established was Impaired Physical Mobility related to neuromuscular disturbances (D.0054). The interventions provided included passive ROM exercises on the left extremities, along with education and family involvement in performing the exercises. After three days of implementation, there was an improvement in mobility, marked by increased muscle strength, limb movement, and range of motion from 3/3 to 4/4. Conclusion: applying Range of Motion (ROM) exercises as part of nursing care can improve physical mobility in stroke patients with physical mobility impairments. This intervention can be used as one of the evidence-based nursing actions to support early rehabilitation and prevent complications from immobilization.